Lupus

Penn rheumatologists apply a multidisciplinary approach to the diagnosis, management and treatment for those with systemic lupus erythematosus. Individuals with lupus are among the most diagnostically and therapeutically complicated patients and often require the highly specialized team approach found at the Penn Lupus Program for optimal management.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease involving the production of autoantibodies and dysregulation of the immune system. Diagnosing SLE can be challenging because every person may present with a unique set of symptoms ranging from a mild skin rash and joint pain to severe, life-threatening disease involving many organ systems.

SLE can adversely affect cardiac, pulmonary, gastrointestinal, hematologic, renal and neurologic function in a variety of ways that have the potential to be life-threatening. SLE has been closely linked to antiphospholipid antibody syndrome which carries the risk of stroke and miscarriage; premature osteoporosis and increased fractures; and early atherosclerosis and myocardial infarctions.

Those with SLE can be afflicted with musculoskeletal symptoms as well as chronic pain syndromes like fibromyalgia. SLE is linked to psychosocial and psychiatric difficulties that can create treatment challenges for both patients and physicians. In addition, the toxicities of the immunosuppressive medications used to treat SLE add to the complexity of balancing the risks and benefits in therapeutic decision making.

Diagnosis and Management

Accurate diagnosis of SLE requires detailed investigation of every symptom with lab and imaging evaluation, as well appropriate referrals to additional subspecialists. Careful assessment of the potential disease manifestations and weighing the elements of the treatment approaches are essential to providing effective care to patients with SLE. Generally this is overseen by the rheumatologist, but frequently involves the expert input from Penn's team of nephrologists, pulmonologists, dermatologists and other specialists.

The physicians of The Lupus Program at Penn Medicine have developed a multidisciplinary approach to achieve this concept of comprehensive care. At the center of the program is a collaborative outpatient practice shared by the divisions of renal-electrolyte and hypertension and rheumatology. As a result, lupus patients with renal disease can schedule office visits with both their nephrologist and rheumatologist on the same day.

In addition to the close cooperation of Penn nephrologists and rheumatologists, the ability of the lupus program to address the needs for multidisciplinary care rests with an extensive network of providers, including: